Diagnostic tardif des cancers du sein au Centre Hospitalier Universitaire Yalgado Ouédraogo (CHU/YO) : Causes, impacts thérapeutiques et pronostiques. A propos de 70 cas

Abstract

INTRODUCTION: Breast cancer is the first cancer of women in Burkina Faso. There remains a relatively late diagnosis and a reserved prognosis. The main aim of this study is to study the causes, therapeutic and prognostic impacts of late diagnosis of breast cancer at Yalgado Ouédraogo University Hospital. MATERIALS AND METHODS: This was a descriptive and prospective study from May 1st to October 31, 2013. The departments of surgery, gynecology and anatomy-pathology served as a framework for our study. All consenting breast cancer patients with a height greater than at least 5 cm (>T2), suspicious or metastatic satellite lymphadenopathy was included. The data analysis was done using Epi-info© software version 7.2.2.6, with the use of the Khi2, Fisher-exact and Student tests. RESULTS: We collected 70 patients with an average age of 46.1 years. In 95.7% of cases, our patients had consulted a traditional therapist or at least one medical center before being referred to the Yalgado Ouédraogo University Hospital. The consultation was less than 6 months in 52.9% of cases. Diagnostic time was statistically associated with source and monthly income with a p-value of 0.03 and 0.05 respectively. Stage III accounted for 62.8% of cases. Surgery was performed in 48.6% of cases, including 23.5% palliative surgery. Chemotherapy was neo-adjuvant in 22%, adjuvant in 48.8% and palliative in 14.6%. The average duration of follow-up was 2.7 months. We had found 20.6% of recidivism and 22% of deaths. CONCLUSION: Poverty, ignorance, socio-cultural constraints and lack of staff reduce patients' access to early diagnosis, which is responsible for expensive complex treatment and a poor prognosis. Equitable financial and geographic access will reduce diagnostic delays and mortality from breast cancer. KEYWORDS: Breast cancer; Late diagnosis; Causes; Treatment; Prognosis.